Provider Demographics
NPI:1477520989
Name:WESTERN CAROLINA WOMENS SPECIALTY CENTER PA
Entity Type:Organization
Organization Name:WESTERN CAROLINA WOMENS SPECIALTY CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LYLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-670-5665
Mailing Address - Street 1:100 RIDGEFIELD CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2207
Mailing Address - Country:US
Mailing Address - Phone:828-670-5665
Mailing Address - Fax:828-670-5663
Practice Address - Street 1:100 RIDGEFIELD CT
Practice Address - Street 2:SUITE B
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2207
Practice Address - Country:US
Practice Address - Phone:828-670-5665
Practice Address - Fax:828-670-5663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89014YCMedicaid
NC2334190Medicare PIN